Factors affecting the adhesion of Candida albicans to epithelial cells of insulin-using diabetes mellitus patients

School of Dentistry and *Department of Microbiology and Immunobiology, School of Clinical Medicine, Queen's University of Belfast and Royal Group of Hospitals Trust, Belfast, Northern Ireland Corresponding author: Dr A. M. Willis (e-mail: a.willis{at}qub.ac.uk ). Received 13 May 1999; revised version received 8 August 1999; accepted 16 August 1999. Abstract This study investigated the influence of the carbon source of the growth medium, strains of Candida albicans and source of epithelial cells, and the influence of smoking and gender, on the adhesion of C. albicans to epithelial cells from insulin-using diabetic patients. Adhesion was determined by an autologous adhesion assay with exfoliated buccal or palatal epithelial cells and one strain of C. albicans isolated from each patient. The type strain CBS 562 was also used. Glucose or sucrose were used as the predominant carbon sources of the growth medium. The autologous strain of C. albicans adhered selectively to the oral mucosa of diabetic patients. Palatal epithelial cells retained significantly more C. albicans in vivo and adhesion was influenced by the availability of sugars in the growth medium and the strain of C. albicans .